O'Connell Susan, Palmer Robert, Withers Kathleen, Saha Neeleem, Puntoni Sarah, Carolan-Rees Grace
HOPE Wales, Cedar Healthcare Technology Research Centre, Cardiff and Vale University Health Board, Cardiff Medicentre, Heath Park, Cardiff, CF14 4UJ UK.
NHS Wales Informatics Service, Tŷ Glan-yr-Afon, 21 Cowbridge Road East, Cardiff, CF11 9AD UK.
Pilot Feasibility Stud. 2018 Jul 4;4:90. doi: 10.1186/s40814-018-0282-8. eCollection 2018.
The patient-reported outcome measures (PROMs), patient-reported experience measure (PREMs) and Effectiveness Programme (PPEP) launched with the aim of supporting all National Health Service Wales (NHS Wales) organisations to collect PROMs and PREMs across a range of conditions. The aim is to collect generic and condition-specific PROMs and PREMs electronically from every secondary care patient in Wales to provide a measure that can be used to determine the clinical and cost-effectiveness of treatments and services. This study reports on the experience of the PPEP in developing an electronic platform suitable for large-scale data collection, storage, analysis and reporting and identifies the problems encountered and solutions implemented using a generic PROM survey as an example.
The generic PROM survey is available in English and Welsh and consists of a consent section and three components: the EQ-5D-5L tool, the Work Productivity and Activity Impairment (WPAI) tool and a number of "about you" questions. The "about you" questions are designed to assess factors which may affect patient health and outcomes such as information on height, weight, smoking history, exercise levels and alcohol consumption. A dedicated PROM database was built, and links between the e-PROM platform and other key clinical databases within NHS Wales were developed.
Pilot testing of the unvalidated sections of the generic electronic PROM found that most of the questions were well understood and easy to answer: however, feedback suggested some improvements and changes were required, specifically around questions relating to alcohol and exercise.Electronic PROM collection has been initiated in six of the seven health boards in Wales and at-home collection initiated in three health boards. More than 9300 patients have completed a PROM survey. Early results from one Health Board show that patients took approximately 10 min to complete the questionnaire with most patients answering an average of 94.7% of the questions.
Successful implementation of a PROM collection programme is dependent on a number of factors including close collaboration with clinicians, analysts, IT specialists and patients to ensure that any electronic system of PROM collection is fit for purpose and user friendly both for patients and clinicians.
患者报告结局测量(PROMs)、患者报告体验测量(PREMs)和有效性计划(PPEP)的推出旨在支持威尔士国民保健服务(NHS Wales)的所有组织收集一系列疾病的PROMs和PREMs。其目标是从威尔士的每一位二级医疗患者中以电子方式收集通用和特定疾病的PROMs和PREMs,以提供一种可用于确定治疗和服务的临床及成本效益的测量方法。本研究报告了PPEP在开发适用于大规模数据收集、存储、分析和报告的电子平台方面的经验,并以通用PROM调查为例,确定了遇到的问题及实施的解决方案。
通用PROM调查有英文和威尔士文版本,包括一个同意部分和三个组成部分:EQ-5D-5L工具、工作效率和活动障碍(WPAI)工具以及一些“关于您”的问题。“关于您”的问题旨在评估可能影响患者健康和结局的因素,如身高、体重、吸烟史、运动水平和饮酒情况等信息。建立了一个专用的PROM数据库,并在NHS Wales内的电子PROM平台与其他关键临床数据库之间建立了链接。
对通用电子PROM未经验证部分的试点测试发现,大多数问题易于理解且易于回答:然而,反馈表明需要一些改进和更改,特别是围绕与酒精和运动相关的问题。威尔士七个卫生委员会中的六个已开始电子PROM收集,三个卫生委员会已开始在家收集。超过9300名患者完成了PROM调查。一个卫生委员会的早期结果显示,患者完成问卷大约需要10分钟,大多数患者平均回答了94.7%的问题。
PROM收集计划的成功实施取决于多个因素,包括与临床医生、分析师、信息技术专家和患者密切合作,以确保任何PROM收集电子系统都符合目的,并且对患者和临床医生都用户友好。